Provider Demographics
NPI:1154471647
Name:BETHESDA ALTERNATIVE, INC.
Entity Type:Organization
Organization Name:BETHESDA ALTERNATIVE, INC.
Other - Org Name:BETHESDA, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTIANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:405-364-0333
Mailing Address - Street 1:1181 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-5331
Mailing Address - Country:US
Mailing Address - Phone:405-364-0333
Mailing Address - Fax:405-364-0342
Practice Address - Street 1:1181 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5331
Practice Address - Country:US
Practice Address - Phone:405-364-0333
Practice Address - Fax:405-364-0342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health